Remote RN Regional Case Manager: Managed Care

Medilodge; Howell (MI); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Medical, Dental, Vision

Benefits Concierge

Pet Insurance

Tuition Reimbursement

Student Loan Repayment

Life Insurance

Paid Vacation & Sick Time

401k with Match

Health Savings Account

Flexible Spending Account

Referral Bonuses

Job summary

MediLodge of Howell in Howell, MI is seeking a Regional Case Manager RN to oversee managed care caseloads in long-term care settings, negotiating rates and authorizations with Medicaid/Medicare and MDS knowledge.

The role collaborates with Operations, Finance, Therapy, and Sales to implement managed care processes; RN preferred with five years in long-term care managed care. Benefits include health coverage, retirement plan, PTO, and loan repayment programs.

Qualifications

• Five years of experience with long-term care related managed care.
• Background in MDS preferred.
• Registered Nurse preferred.

Responsibilities

• Review managed care contracts for facilities and ensure alignment with regional contracts.
• Negotiate rates, levels and exclusions with managed care organizations.
• Obtain authorizations, re-authorizations and notifications for new managed care patients.
• Train facility staff on pre-admission case management processes for regional contracts.
• Collaborate with Sales, Marketing, Business Office, Therapy and Clinical teams to deliver contracted services.

Skills

Case management

Microsoft Excel

Microsoft Word

Education

RN preferred

Job description

MediLodge of Howell in Howell, MI is seeking a Regional Case Manager RN to oversee managed care caseloads in long-term care settings, negotiating rates and authorizations with Medicaid/Medicare and MDS knowledge.

The role collaborates with Operations, Finance, Therapy, and Sales to implement managed care processes; RN preferred with five years in long-term care managed care. Benefits include health coverage, retirement plan, PTO, and loan repayment programs.